Topical Glaucoma Medications May Increase Ocular Adnexal Disorder Risk

Topical glaucoma medication use may be associated with an increased risk for lacrimal drainage obstruction, entropion, and trichiasis, according to research published in Eye.

The retrospective cohort study included 122,582 individuals treated with topical glaucoma medications (mean age, 75.7 years; 57.2% women) and 232,336 age- and sex-matched control group participants with glaucoma or glaucoma suspects who were not treated with topical glaucoma medications (mean age, 75.3 years; 56.6% women). Researchers used validated healthcare administration databases to match patients using topical glaucoma medications with individuals not using topical glaucoma medications based on birth year and sex (1:2 matching) and estimated the effect of topical glaucoma medication on surgical risk. 

Patients who used topical glaucoma medications had an increased risk for entropion (hazard ratio [HR], 1.24; 95% CI, 1.12-1.37; P <.001), trichiasis (HR, 1.74; 95% CI,

1.57-1.94; P <.001), and lacrimal drainage obstruction (at 15 years: HR 2.39; 95% CI 1.49-3.85; P =.004), according to the report. The risk for ectropion, however, was decreased among those treated with topical glaucoma medications compared with control group participants (HR, 0.89; 95% CI, 0.81-0.97; P =.008). No associations between topical glaucoma medication use and ptosis were noted.

“In this population-level study of patients starting [topical glaucoma medications], we found that use of these medications is associated with a small increase in the long-term risk of undergoing surgery for [lacrimal drainage obstruction], entropion, and trichiasis and a decreased risk of ectropion surgery. These findings may support the growing role for therapies that reduce or delay [topical glaucoma medication] use, such as laser trabeculoplasty and novel drug delivery systems.”

Study limitations include a retrospective nature, failure to stratify patients according to specific topical glaucoma medication, and the exclusion of patients younger than 66 years.